Incidence of tuberculosis in HIV-infected adults on first- and second-line antiretroviral therapy in India

Gupte, Akshay; Kadam, Dileep; Sangle, Shashikala; Rewari, Bharat Bhushan; Salvi, Sonali; Chavan, Amol; Nimkar, Smita; Golub, Jonathan E.; Gupte, Nikhil; Gupta, Amita; Marbaniang, Ivan; Mave, Vidya

doi:10.1186/s12879-019-4569-z

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…Subgroup analysis by study population of the current study showed that the pooled TB incidence among adults and children was slightly different which were 5.01 (95% CI 3.51, 6.50) and 4.34 (95% CI 2.96, 5.71) respectively. This finding was consistent with studies done in India in 2019 and Tanzania in 2015 which were 4.39 cases and 4.4 cases per 100 PYO, respectively [ 27 , 28 ]. This might be the same socioeconomic status between these countries.…”

Section: Discussionsupporting

confidence: 92%

“…The current study revealed that the pooled TB incidence among HIV-infected patients after initiation of ART was 4.76 (95% CI 3.69–5.83) per 100 PYO which was in line with the primary studies done in India in 2019 and Tanzania in 2015 which were 4.39 cases and 4.4 cases per 100 PYO, respectively [ 27 , 28 ]. The current finding of pooled incidence was higher than studies conducted in higher-income countries in 2012, Asia in 2019, Brazil and Nigeria in 2017, and South Africa in 2005 which were 0.3, 0.99, 1.90, 0.57, and 2.44 per 100 person-years, respectively [ 29 – 33 ].…”

Section: Discussionsupporting

confidence: 87%

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Incidence and predictors of tuberculosis among HIV patients after initiation of antiretroviral treatment in Ethiopia: a systematic review and meta-analysis

et al. 2021

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Background Tuberculosis is the oldest infectious disease and it is still the leading cause of morbidity and mortality worldwide. Even though several primary studies have been conducted on the incidence of tuberculosis among HIV-infected individuals in Ethiopia, national-level tuberculosis incidence is unknown. Therefore, this study is aimed to assess the TB incidence rate and its predictors among HIV-infected individuals after the initiation of ART in Ethiopia. Methods We conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, and HINARI literature. We used the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. The meta-analysis and Meta regressions were conducted using STATA 14 software. Met-analysis and meta-regression were computed to present the pooled incidence rate and predictors of tuberculosis among HIV-infected patients after initiation of ART with a 95% confidence interval. Results Among a total of 189 studies, 11 studies were included in this analysis. The estimated pooled incidence rate of TB per 100-person year observation (PYO) among HIV-infected patients after initiation of ART therapy was 4.8(95% CI 3.69–5.83). In subgroup analysis, the estimated pooled incidence of tuberculosis showed a slight difference between adults and children after initiation of ART treatment, which was 4.3 (95% CI 2.96, 5.71) and 5.0 (95% CI 3.51, 6.50), respectively. Significantly pooled estimates of predictors of TB incidence by a meta-analysis were being anemic (2.30, 95% CI 1.75, 3.02); on clinical stages III and IV (2.26, 95% CI 1.70, 3.02); and not on cotrimoxazole preventive therapy (CPT) (2.16, 95% CI 1.23, 3.72). Besides, a meta-regression revealed that CD4 <200 cells/mm3 (2.12, 95% CI 1.17, 3.86) was a positive significant predictor of TB among HIV patients after the initiation of ART. Conclusions The current study showed that the pooled incidence of TB among HIV patients was found to be lower than the WHO 2018 national estimate. Being anemic, WHO stages III and IV, not on CPT, CD4<200cells/μl, and being male were significant predictors of tuberculosis. Therefore, the existing strategies to decrease TB should be strengthening. Study protocol registration CRD42020155573.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Incidence and predictors of tuberculosis among HIV patients after initiation of antiretroviral treatment in Ethiopia: a systematic review and meta-analysis

et al. 2021

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show abstract

“…Subgroup analysis by study population of this study showed that the pooled TB incidence among adults and children was slightly different which were 5.01 (95% CI: 3.51, 6.50) and 4.34 (95% CI 2.96, 5.71) respectively. This finding was consistent with studies done in India in 2019, and Tanzania in 2015 which were 4.39 cases, and 4.4 cases per 100 PYO, respectively (27,28). This might be the same socioeconomic status between these countries.…”

Section: Discussionsupporting

confidence: 92%

“…The pooled TB incidence among HIV infected patients of this study revealed that 4.76 (95% CI; 3.69-5.83) per 100 PYO which was in line with the primary studies done in India in 2019, and Tanzania in 2015 which were 4.39 cases, and 4.4 cases per 100 PYO, respectively (27,28). The current finding of pooled incidence was higher than studies conducted in higher-income countries in 2012, in Asia in 2019, in Brazil, Nigeria in 2017 and South Africa 2005 which were 0.3, 0.99, 1.90 and 0.57 and 2.44 per 100 person-years, respectively (29)(30)(31)(32)(33).…”

Section: Discussionsupporting

confidence: 88%

Incidence and Predictors of tuberculosis among HIV patients after initiation of ART treatment in Ethiopia: A systematic review and Meta-analysis

Azanaw

Derseh

Yetemegn

et al. 2019

Preprint

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Background: Tuberculosis is the oldest infectious disease and it is still the leading cause of morbidity and mortality worldwide. Even though, several primary studies have been conducted on incidence of tuberculosis among HIV infected individuals in Ethiopia, national level TB incidence is unknown. Therefore, this systematic review and meta-analysis study is aimed to study TB incidence rate and its predictors among HIV infected individuals in Ethiopia. Methods: We conducted extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, HINARI and Scopus literature. Searching terms used were “incidence”, “predictors”, “Tuberculosis”, “HIV infected patients”, and “Ethiopia”. We used Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. The meta-analysis and Meta regressions were conducted using STATA 14 software. The pooled meta-analysis and Meta regression were computed to present the pooled incidence rate and predictors of tuberculosis among HIV infected patients after initiation of ART therapy with a 95% confidence interval Results: Among a total of 189 studies, 11 studies were included in this analysis. The estimated pooled incidence rate of TB per 100-person year observation (PYO) among HIV infected patients after initiation of ART therapy was 4.8(95% CI: 3.69–5.83). In subgroup analysis, the estimated pooled incidence of tuberculosis showed a slightly difference between Adults and children after initiation of ART treatment, which was 4.3 (95% CI: 2.96, 5.71) and 5.0 (95% CI: 3.51, 6.50), respectively. Significant predictor of pooled estimate of meta-analysis showed that being anemic patients (2.30, 95% CI: 1.75, 3.02); on WHO clinical stage III & IV (2.26, 95% CI (1.70, 3.02); and not on CPT (2.16, 95% CI: 1.23, 3.72) and a Meta regression revealed that CD4 <200 cells/mm 3 (2.12, 95% CI: 1.17, 3.86) was positively significant predictors among Adults. Conclusions: The current systematic review and meta-analysis showed that the pooled incidence of TB among HIV patients was found to lower than WHO 2018 national estimate. Being anemic, WHO stage III& IV, not on CPT, CD4 <200cells/µl and being male were significant predictors of Tuberculosis. Therefore, the existing strategies to decrease TB should be strengthening.

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“…In our study, we found higher TB incidence among males compared to females. In general, males show an increased TB prevalence compared with females [ 13 , 14 ], and some studies have also shown that male sex is associated with a higher risk of TB incidence among PLHIV, independent of any ART regimen [ 15 ]. Even though in our study the adjusted analysis did not show a major association between male sex and higher TB incidence, there was a strong association between male sex and lower CD4 cell count at diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Incidence Rate and Risk Factors for Tuberculosis among People Living with HIV: A 2015–2017 Cohort from Tashkent, Uzbekistan

Sadirova

Grigoryan²,

Parpieva

et al. 2021

IJERPH

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People living with the human immunodeficiency virus (PLHIV) have a higher risk of developing active tuberculosis (TB) disease, and TB remains a major cause of death in PLHIV. Uzbekistan is facing a substantial TB epidemic, which increases the risk of PLHIV developing active TB. Our retrospective cohort study aimed to evaluate the incidence rate and assess the risk factors for developing active TB among PLHIV. We collected secondary data extracted from medical charts of all patients, newly diagnosed at the AIDS Center in Tashkent, during the period of 2015–2017. The incidence rate of TB among PLHIV was 5.1 (95% CI: 4.5–6.0) per 1000 person/month. Adjusted regression analysis showed three major risk factors for TB, namely, being less than 15 years old (hazard ratio (HR) 5.83; 95% CI: 3.24–10.50, p value = 0.001),low CD4 count (adjusted hazard ratio(aHR) 21.0; 95% CI: 9.25–47.7, p value < 0.001), and antiretroviral therapy (ART) interruption/not receiving ART (aHR 5.57; 95% CI: 3.46–8.97 and aHR 6.2; 95% CI: 3.75–10.24, p value < 0.001, respectively) were significantly associated with developing active TB among PLHIV. Our findings indicate that taking prescribed ART without interruptions and maintaining CD4cell counts higher than 320 cells/μL are essential to prevent the development of active TB among PLHIV.

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Incidence of tuberculosis in HIV-infected adults on first- and second-line antiretroviral therapy in India

Cited by 9 publications

References 19 publications

Incidence and predictors of tuberculosis among HIV patients after initiation of antiretroviral treatment in Ethiopia: a systematic review and meta-analysis

Incidence and predictors of tuberculosis among HIV patients after initiation of antiretroviral treatment in Ethiopia: a systematic review and meta-analysis

Incidence and Predictors of tuberculosis among HIV patients after initiation of ART treatment in Ethiopia: A systematic review and Meta-analysis

Incidence Rate and Risk Factors for Tuberculosis among People Living with HIV: A 2015–2017 Cohort from Tashkent, Uzbekistan

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